Revenue Integrity Specialist
VNA of Care New England
Revenue Integrity Charge Capture Specialist
The Revenue Integrity Charge Capture specialist is responsible for ensuring the complete, accurate, and timely capture of hospital and professional charges across Care New England. This role focuses on proactive review and resolution of missing or incorrect charges through daily monitoring of Epic Revenue Guardian reports and charge-related work queues, reconciliation of charges against clinical documentation, and collaboration with operational, clinical, and coding teams to ensure compliance with federal, state, and third-party payor guidelines.
The Analyst supports charge integrity by verifying that all services provided are appropriately documented and coded using ICD-10-CM, CPT, and HCPCS classification systems. They perform reconciliation activities to identify gaps or discrepancies in revenue capture, work to correct systemic or documentation-related issues, and escalate concerns as needed.
In addition, the Analyst assists with data extraction and reporting, trend identification, and audit preparedness. This role is a vital member of the Revenue Integrity team and serves as a resource to coding, billing, and operational staff regarding charge accuracy, workflow compliance, and revenue optimization strategies. The Analyst plays a critical role in maintaining data integrity, reducing revenue leakage, and supporting a compliant billing environment across the organization.
Duties & Responsibilities
- Review daily Epic Revenue Guardian reports and charge-related work queues to identify and correct missing, incomplete, or inaccurate charges.
- Validate charge capture processes are functioning as expected and escalate systemic issues to the Manager of Revenue Integrity.
- Reconcile clinical documentation against charge activity to ensure all services rendered are accurately reflected and captured.
- Collaborate with clinical departments to clarify documentation discrepancies or omissions impacting charging.
- Maintain working knowledge of Medicare, Medicaid, and commercial payor billing requirements, including CMS guidelines.
- Apply accurate CPT, HCPCS, and ICD-10 codes during charge validation; escalate issues that need further review.
- Serve as a liaison between Revenue Integrity, Coding, Clinical Operations, and Patient Financial Services to resolve charge-related issues.
- Communicate professionally and promptly with departments regarding trends, discrepancies, or needed workflow adjustments.
- Assist in compiling or addressing daily, monthly, and ad hoc charge-related reports for internal use and leadership review as needed.
- Prepare and organize documentation to support internal and external audit activities as needed.
- Participate in reviews of CDM (Charge Description Master) and charge workflows for accuracy and efficiency.
- Identify opportunities to streamline charge capture processes, reduce errors, and improve documentation practices.
- Assist in the development of training materials or process documentation as needed.
- Ensure all patient and financial information is handled in compliance with HIPAA regulations and organizational policies.
- Demonstrate accountability and initiative in meeting expectations of timeliness, accuracy, and integrity.
Requirements
- High School or GED Required; Associate's Degree Preferred
- Minimum 3 to 5 Years
- Strong working knowledge of CPT, HCPCS, and ICD-10 coding systems and their application to charge capture and reimbursement.
- Comprehensive understanding of healthcare revenue cycle operations, particularly front-end processes and professional/facility charge capture.
- Familiarity with Medicare, Medicaid, and commercial payer billing and reimbursement guidelines.
- In-depth knowledge of Epic (or comparable EHR/EMR systems), including work queues and Revenue Guardian reporting tools.
- Understanding of compliance regulations including HIPAA and CMS guidelines related to billing practices.
- Awareness of Charge Description Master (CDM) structure and its impact on charging and reimbursement.
- High level of attention to detail, with the ability to review clinical documentation for accurate translation into billable services.
- Strong analytical skills to identify trends, discrepancies, and root causes of charge capture issues.
- Effective written and verbal communication skills, with the ability to explain complex charge or documentation issues clearly.
- Proficiency in Microsoft Excel and other reporting tools to extract, analyze, and present data.
- Time management and organizational skills to manage multiple tasks and meet daily/weekly deadlines.
- Ability to build productive relationships and collaborate across departments (clinical, billing, IT, compliance).
- Ability to work independently while using sound judgment to escalate concerns when appropriate.
- Ability to interpret and apply regulatory changes and payer guidelines to operational workflows.
- Ability to navigate Epic and other systems to resolve charge capture issues efficiently.
- Ability to assess workflow inefficiencies and recommend process improvements.
- Ability to manage competing priorities and shift focus quickly in a dynamic environment.
- Commitment to maintaining confidentiality and upholding the highest standards of integrity and professionalism.
Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation's top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. Care New England is helping to transform the future of health care, providing a leading voice in the ongoing effort to ensure the health of the individuals and communities we serve.
Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.
EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.
- ...Revenue Cycle Specialist #4323 Position: Revenue Cycle Specialist #4323 Site: Warwick Response Date: September 4 2026 Job Transfer Date: Employees transfer to the posted position within seven (7) weeks of job offer acceptance date and receive new hourly rate...SuggestedHourly payContract workMonday to Friday
$20 - $23 per hour
...We are seeking a Professional, High Energy Revenue Cycle Representative/ Medical Receptionist to help us provide excellent customer service and quality of care to our patients. Company description : Aspire Dermatology, with twelve offices conveniently located throughout...SuggestedHourly payFull timeWork at officeMonday to FridayFlexible hoursDay shift- ...analyst within the Clinical Informatics Department to support revenue cycle operations through data analysis, reporting, and revenue... ...improvements can enhance billing accuracy, reimbursement, and revenue integrity This role strengthens the Clinical Informatics...SuggestedRemote work
$19 per hour
...Asset Protection Specialist 4280 - WARWICK Job Description Position Purpose: The Asset Protection Specialist is primarily responsible... ..., vendors, customers, and the Company. They must demonstrate integrity at all times, respond to asset protection and operational...Suggested- ...is everything and that starts with you. As an Asset Protection Specialist (APS), youre not just a security presence, youre the warm,... ...managers. Operate with a high level of professionalism and integrity, including dealing with confidential information and complying...SuggestedWork at officeLocal areaShift workNight shiftWeekend workDay shift
$52k
...implementation of National program evaluation measures. If applicable - Support organizational fundraising efforts by meeting assigned revenue goals, conducting prospect research for potential partners, soliciting financial or in-kind contributions, and assisting with the...Temporary workLocal areaFlexible hours- ...Third Party Specialist Under the direction of the A/R Supervisor, the Third Party Specialist facilitates all phases of the billing... ...Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in...Local area
$22.04 - $36.37 per hour
...Authorization Specialist The Authorization Specialist is responsible for securing timely and accurate insurance authorizations... ...role ensures compliance with payer requirements, supports revenue cycle integrity, and plays a critical part in optimizing financial...Work at officeShift work- ...Revenue Cycle Analyst Data Science/Big Data Our client in Providence, RI is seeking a Revenue Cycle Analyst to support revenue cycle operations through data analysis, reporting, and revenue cycle system support. This non-clinical role sits within the Clinical Informatics...
$25 - $29 per hour
...Relief and Proof of Claim figures Our Company: Carrington Mortgage Services is part of The Carrington Companies, which provide integrated, full-lifecycle mortgage loan servicing assistance to borrowers and investors, delivering exceptional customer care and programs...Extra incomeWork experience placementWork from home- ...Referral And Authorization Specialist The Referral And Authorization Specialist plays a vital and strategic role in supporting the... ...centralizing and streamlining the authorization workflow, which is integral to the success of the organization's operations, patient...Work at office
- ...What to expect when you work here. As a Receiving Specialist, you will be responsible for managing the store's backroom operations by receiving products into the POS system, keeping products organized and accounted for, and helping process weekly pal Receiving Specialist...
$30 per hour
...Program (OVIP): Oracle is proud to sponsor an internship and integration program that exposes transitioning military veterans and... ...innovations for our customers, partners, and communities. With annual revenue of US$57 billion in FY2025, Oracle is the world's largest EHR...Hourly payTemporary workWork experience placementInternshipWorldwideFlexible hours- ...Delivery Specialist The Delivery Specialist will maintain and operate store vehicles to deliver parts and/or products to professional customers in a safe and efficient manner. This position will also collect money on C.O.D. deliveries and pick up customer returns....Local areaImmediate startRemote workFlexible hours
- ...Record Center Specialist Record Center Specialists have to kneel, squat, reach, and bend forward frequently throughout their shifts. Their primary tasks include the moving, arranging, lifting and loading of storage boxes, bins and totes. Boxes, bins and totes range...Local areaFlexible hoursShift work
- ...Record Center Specialist 1 Our client, a leading organization in document management and storage solutions, is seeking a Record Center Specialist 1 to join their team. As a Record Center Specialist 1, you will be part of the operations team supporting the physical...Permanent employmentTemporary workFlexible hoursShift work
- ...to deliver the best for our employees and our customers. We're known for being: Innovative & adaptable Dedicated to absolute integrity Focused on the customer first Respectful and team oriented Optimistic and energizing Accountable for performance...Full timeTemporary workWorldwideFlexible hours
- ...Call Center Specialist Rhode Island Parent Information Network - Warwick, RI 02888 RIPIN deploys a peer model to support people with special healthcare and education needs across the whole lifespan. Founded in 1991 by a group of parents of children with special...Work at officeLocal areaWeekend workAfternoon shift
$65k
...DesignerWorks collaboratively with members of the department, faculty, and academics to enhance teaching and learning through the effective integration of instructional design principles and instructional technology.Essential Job FunctionsSupports course development, offers...Full timeRelocationFlexible hours- Job Title This position will transition to a hybrid role once the employee is fully trained and receives management approval. Training will be completed on-site at our corporate office in Warwick, RI. Job Description Responsible for obtaining prior authorizations...Work at officeLocal areaMonday to FridayFlexible hours
- ...Westaff is seeking a Purchasing Specialist in Warwick, RI for immediate start. The role focuses on processing high volumes of purchase orders, confirming orders, and coordinating with vendors and internal teams. Ideal candidates have 1–3 years of purchasing experience...Full timeWork at officeImmediate start
- ...Intake Specialist (800144)We help job seekers and career changers prepare for and advance in careers with a focus on sustainable, high... ...workforce professionals deliver comprehensive workforce solutions at integrated career centers, sector-focused centers and community, and...Local areaWeekend workAfternoon shift
- ...Providence Center Substance Use Specialist CCBHC This position is eligible for $2500 retention bonus. The Providence Center Substance... ...Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical...Work at office
- ...Record Center SpecialistRecord Center Specialists have to kneel, squat, reach, and bend forward frequently throughout their shifts. Their primary tasks include the moving, arranging, lifting and loading of storage boxes, bins and totes. Boxes, bins and totes range in weight...Local areaFlexible hoursShift work
- ...Substance Use Specialist Team 1F This position is eligible for $2500 retention bonus. The Providence Center Substance Use Specialist... ...Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical...Flexible hours
- ...financial analysis. Ensures 340B claims meet eligibility criteria. Assist the Executive Director, Accountable Entity in maximizing 340B Revenue. Demonstrates advanced proficiency in data management and Microsoft Office, along with the ability to work independently through...Work at office
- ...The Parts Specialist will provide all retail and installer customers with a high level of service. This position will also support store management in the accomplishment of assigned tasks. Bilingual candidates encouraged to apply. ESSENTIAL JOB FUNCTIONS...Local areaFlexible hours
$22.04 - $36.37 per hour
...and external customers. Demonstrates flexibility and innovation to facilitate the changes required to improve operations, enhance revenue, effectiveness, productivity, responsiveness, and other key indicators. Demonstrates ability to respond to and provide direction on...Daily paidSecond jobWork at officeAll shiftsShift work- Job Summary: The Providence Center Peer Recovery Specialist CCBHC provides peer support services, serves as a client advocate, and provides... ..., spiritual, social, recreational, financial, and community integration and recovery-focused needs and supports. ~Provide services...Work at office
$28.09 - $30.69 per hour
...North Providence Public Schools is seeking to hire a Behavioral Specialist to join our team at Whelan Elementary School. Schedule: - 7.... ...teachers and special subject teachers to implement an integrated educational model. # Complete all reporting requirements as...Hourly pay
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Revenue Integrity Specialist. Be the first to apply!
- welding specialist Warwick, RI
- transportation specialist Warwick, RI
- e learning specialist Warwick, RI
- employment specialist Warwick, RI
- deployment specialist Warwick, RI
- localization specialist Warwick, RI
- order entry specialist Warwick, RI
- electronic health record specialist Warwick, RI
- veterinary internal medicine specialist Warwick, RI
- international relations specialist Warwick, RI


